I’ve Heard About Egg Donors for Infertility—What’s the Deal?

Egg Donor Infertility

Most women have kind of a weird relationship with their ovaries and eggs: they go through life completely forgetting those little baby-making vessels exist…until they really, really need one. And if you’re a guy, up until this point, you may have never even thought about how eggs fit into the whole conception process. But trust us, they’re important. So important that many women and couples facing infertility end up going the egg donor route.

Think about it: what happens when you’re ready to have a baby, but a) you don’t have any eggs left, b) the eggs still around aren’t working the way they’re supposed to, or c) you never had any eggs in the first place, ’cause you and your partner are both men?

Yeah, we know—using an egg donor can be a little hard to wrap your head around at first. Let us help with that! If you’re thinking about taking the plunge into egg donation, here’s everything you need to know about how it works.

What kinds of people need donor eggs?

There’s a wide variety of singletons and couples who might consider egg donation in order to have a baby. According to Dr. Mark Leondires, reproductive endocrinologist and founder of Reproductive Medicine Associates of Connecticut, this list includes:

  • Young women, single or with a partner, who have premature ovarian failure (i.e. little or no eggs left)
  • Couples suffering from infertility because the woman’s eggs aren’t fertilizing or developing successfully
  • Older or menopausal women, either single or with a partner
  • Single men or same sex male couples (who’ll also have to line up a surrogate)

Got it. But what kinds of people donate eggs?

Egg donors go through a rigorous vetting process, says Dr. Leondires, one that includes mental health screening as well as infectious disease screening. He says only about 7% of potential donors pass the credentialing process, which often starts with egg banks or fertility clinics recruiting healthy, young females via advertisements. From there, prospective donors are screened, tested, and required to sign informed consent forms about the medications they’ll be placed on.

Unknown donors are compensated well for their efforts (more on that later!), so many of them do it for the income it provides. If you’re using a known donor—like a friend or family member—they’re probably volunteering to donate their eggs because they really, really love you and want to help you become a parent. Isn’t that nice of them?!

What was all that about medications? This sounds waaaay more complicated than sperm donation.

That’s because it is! Donating sperm is an easy way for guys to cash in on their reproductive abilities; as long as a man passes a health screening, for the most part, he decides how much personal information he wants revealed about himself, donates his swimmers, and moves on.

Egg donors, on the other hand, need to be induced into something called “super ovulation” with an ovulation-stimulating injectable drug, says Dr. Leondires, prior to being able to donate any eggs. Unfortunately for donors, “super ovulation” doesn’t mean they acquire reproductive superpowers (!), but that they’re able to produce multiple eggs for a single donation procedure.

Meanwhile, the egg recipient will also have to take some hormonal medication. Depending on your fertility center’s practice, the recipient may be taking hormones to sync her cycle with a fresh embryo transfer. Alternatively, she will take hormones in prep for a frozen embryo transfer cycle. The American Pregnancy Association notes that this helps create an optimal endometrial environment (a.k.a. a friendly uterus) for a future transferred embryo.

If I’m using an unknown donor, how do I pick one?

First, you’ll have to decide whether to go with fresh or frozen eggs. Fresh eggs are more common, but in some cases may require you to match up with a donor prior to the donation process. Transportation and scheduling logistics, overall cost, using a known vs. unknown donor, and the actual number of eggs you want are just some of the factors that play a part in this decision.

If you decide to use an unknown donor from a bank or clinic, you’ll be able to search for donors online in a database full of options—everything from physical appearance and ethnic background to intelligence and personality. You could even, in theory, find a donor that shares many of your own characteristics.

What if I want to use my sister’s eggs?

Dr. Leondires says this is actually pretty common, either by one sister donating to another sister who has infertility or a sister donating to her gay brother. But there’s a lot of potential pitfalls here: you’ll want to talk about what relationship, if any, the donor will have with your child; how many times she would be willing to donate eggs if the first attempt doesn’t work; and how she might react if she suffers from infertility herself when trying to start her own family.

There’s also a series of legal hoops to jump through with known donors in addition to a mental health consultation to make sure everyone is on board with what’s best for the child and a legal agreement to protect everyone’s rights.

What kind of rights are we talking about?

  1. Yours, so you can maintain custody of your child as the sole parent or co-parent (with your spouse/partner) without worrying about the egg donor suing for custody or parental rights later.
  2. Theirs, so your egg donor can’t be sued for child support in the future.
  3. Your child’s, so they never have to be dragged into court for a painful custody battle between the parents who’ve raised them and their egg donor.

If you use a donor through an egg bank, these legal protections will be automatically given to all parties involved.

How the heck do the eggs get from the donor to the mother?

Good question. Dr. Leondires breaks down the steps:

  • First, the donor will head to the fertility clinic after about 10 days of using injectable medication. Her ovaries will be the size of grapefruits (for jaw-dropping reference, ovaries are usually the size of clementines, so yeah…now they’re huge).
  • Then, she’ll be put to sleep under general anesthetic. Egg retrieval is a quick surgical procedure. The doctor extracts the fluid and eggs from the donor’s ovaries.
  • Next, the eggs are fertilized with the intended male partner’s sperm; this is the start of in vitro fertilization (IVF). The embryos are grown in a lab for 5 days. They’re carefully monitored to determine which one(s) are considered the best quality.
  • Finally, after 5 days (and any additional time for genetic testing), any high quality embyros are frozen until ready to be used. Or, alternatively, the best quality embyro is selected to be implanted into the recipient in a simple transfer procedure that completes the IVF process.

According to the Society for Assisted Reproductive Technology (SART), about 50% of women using fresh donor eggs will have a live birth and about 36% will have a live birth using frozen donor eggs. Of course, overall quality of eggs and sperm contribute to the success rate, as does the age and health of the egg recipient.

This all sounds…expensive.

Unfortunately, it kind of is. Dr. Leondires says that some donor expenses (like the stimulation process) may be covered under insurance plans, but that the actual compensation for donors is always paid for out-of-pocket. Egg Donor America says this compensation covers medical, legal, and travel expenses as well as insurance, and could cost upwards of $10,000 for one batch of eggs (especially if you’re looking for a donor with specific ethnic or genetic qualities). So it’s an investment, to put it mildly.

I’m worried that it won’t feel like my baby…

This is totally normal. Dr. Michael Grossman, reproductive endocrinologist at CNY Fertility in New York, says that the conversation about egg donation often starts with a hopeful mother-to-be expressing concern that using a donor egg just won’t be the same as using one of her own.

He adds this is an understandable but unnecessary worry: your blood will flow through your placenta, you’ll feel your baby kicking and moving, and you’ll give birth to your baby. You’re definitely his or her mother. That being said, if you’re feeling these emotions, it’s best to explore them with your partner and a licensed psychotherapist, especially one with a focus on infertility issues. This is heavy stuff, and you shouldn’t have to go it alone.

So using an egg donor is easier said than done, but totally possible?

Yep, pretty much. There are legal, financial, and emotional complications to consider, but your reproductive endocrinologist can talk you through all of them, so definitely make an appointment if you think using a donor egg might be your next step.

Sarah Bradley

Sarah Bradley is a freelancer writer from Connecticut, where she lives with her husband and three sons. Her reported features and personal essays in the parenting and women's health spheres have appeared at On Parenting from The Washington Post, Real Simple, Women's Health, Parents, Lifehacker's Offspring, and Romper, among others.